April 14, 2004
Because sedation is a continuum, it is not always possible
to predict how an individual patient will respond. Due
to the potential for rapid, profound changes in sedative/anesthetic
depth and the lack of antagonistic medications, agents
such as propofol require special attention.
Whenever propofol is used for sedation/anesthesia, it
should be administered only by persons trained in the
administration of general anesthesia, who are not simultaneously
involved in these surgical or diagnostic procedures. This
restriction is concordant with specific language in the
propofol package insert, and failure to follow these recommendations
could put patients at increased risk of significant injury
or death.
Similar concerns apply when other intravenous induction
agents are used for sedation, such as thiopental, methohexital
or etomidate.
*This statement is not intended to apply when propofol
is given to intubated, ventilated patients in a critical
care setting.